Last year in the UK over 60,000 cancer patients enrolled on clinical trials aimed at improving cancer treatments and making them available to all.
A trial of afatinib for people with non small cell lung cancer who cannot have chemotherapy (TIMELY)
We know that this is an especially worrying time for people with cancer and their family and friends. We have separate information about coronavirus and cancer. Please read that information alongside this page. We will update that information as guidance changes.
Please note - this trial is no longer recruiting patients. We hope to add results when they are available.
This trial is looking at afatinib (also known as BIBW 2992) for non small lung cancer (NSCLC) in people who cannot have chemotherapy. The trial is supported by Cancer Research UK.
Doctors often treat non small cell lung cancer with chemotherapy. But some people are not well enough to have chemotherapy, or they choose not to have this type of treatment. In this trial, researchers are looking at a drug called afatinib to see if it helps people in this situation.
Drugs that target EGFR are more likely to work if the cancer cells have a change (
Lung cancer is often linked to smoking, but people with lung cancer who have never smoked or were light smokers in the past, are more likely to have cancer with an EGFR gene change.
The aim of the study is to see if afatinib helps to stop the growth of non small cell lung cancer in people who have (or are suspected to have) a change to the EGFR gene change.
Who can enter
You may be able to enter this trial if you
- Have a non small cell lung cancer (NSCLC) and can’t have treatment aiming to cure your cancer (radical treatment)
- Are not well enough to have chemotherapy, or have chosen not to have it
- Have cancer that can be measured on a scan
- Have satisfactory blood test results
- Are at least 18 years old
- Are willing to use reliable contraception during the trial and for 4 weeks afterwards if there is any chance you or your partner could become pregnant
To take part in this trial, you must have a change (a mutation) to the EGFR gene, or your doctor suspects you have a change to the gene but there isn’t a suitable sample of your cancer available to test for this, or a sample was looked at but it wasn’t possible to see if there was a change, or this type of testing is not currently available for you.
If it is suspected that you have a change to the EGFR gene, you must
- Have a type of NSCLC called adenocarcinoma
- Never have smoked, or you stopped smoking more than a year ago and were only a light smoker before that or you didn’t smoke for very long (the trial team can advise you about this)
If it is confirmed that you have a change to the EGFR gene, you can be a smoker and have any type of NSCLC.
As well as the above, if you have a change to the EGFR gene, you must be well enough to be up and about for at least some of each day, even if you need help looking after yourself (performance status 0, 1, 2 or 3). If it suspected that you have the gene change, you must be well enough to be up and about for at least half the day (performance status 0, 1 or 2).
You cannot enter this trial if you
- Have cancer that has spread to your brain unless this has been treated, has not got worse for at least 4 weeks, you don’t take drugs to prevent fits and if you take steroids, have been having the same dose for at least a month
- Have already had chemotherapy for NSCLC that has come back or spread to another part of your body (you may be able to take part if you had chemotherapy before or after surgery to try to stop your cancer coming back as long as this was at least a year ago)
- Have already had afatinib or a similar drug
- Have had surgery in the last 4 weeks
- Have had radiotherapy in the last 2 weeks (or earlier if it was palliative radiotherapy to a single area of cancer)
- Have had another experimental drug in the last 8 weeks
- Are having any other anti cancer treatment
- Cannot swallow or absorb drugs that you take by mouth, or have problems with your
digestive systemsuch as diarrhoea
- Have a lung condition called interstitial lung disease
- Have had any other type of cancer in the last 5 years apart from non melanoma skin cancer or carcinoma in situ of the cervix
- Have had a heart attack in the last 6 months or have certain other heart problems - the trial doctors can advise you about this
- Have an infection or any other medical condition that the trial doctors think could affect you taking part
- Are known to be HIV positive or have hepatitis
- Use alcohol or drugs in a way that is a cause for concern
- Are known to be allergic to afatinib or anything in it
- Are pregnant or breastfeeding
This phase 2 trial will recruit 37 people. Everybody taking part has afatinib.
You take afatinib tablets every day an hour before eating or at least 3 hours after a meal. You keep a diary at home to note down when you take your tablets, any side effects you have and how much water you drink each day.
As long as you don’t have bad side effects, you can carry on taking afatinib for as long as it helps you.
If your cancer gets worse and you stop taking afatinib, the trial team will ask to take a sample of your cancer (a
You see the trial doctors and have some tests before you start the trial treatment. The tests include
- Physical examination
- Chest X-ray
- CT scan
- Blood tests
- Urine test
- Heart trace (
You will have a bone scan if your doctor thinks your cancer may have spread to your bones.
You go to hospital
- Every 2 weeks for the first 8 weeks
- Once a month for the rest of the 1st year of treatment
- Every 2 months after that
You have a physical examination and blood tests at each visit. You may have an ECG. You have a CT scan after 4 weeks of treatment and then every 2 months for a year. If you carry on taking afatinib for longer than a year, you then have a CT scan every 3 months.
When you finish treatment, you see the trial team every 2 months until a year has passed since you started treatment, and then every 3 months after that.
As afatinib is still quite a new drug, there may be side effects we don’t know about yet. The known side effects include
- Skin reactions such as a rash or dry skin
- Sore mouth
- Nail changes
- Tiredness (fatigue)
- Feeling or being sick
- Eye problems (you must tell the trial team if you get red, dry or watery eyes, blurred vision, irritation or eye pain)
- Swelling (inflammation) of your lungs (you must tell the trial team if you begin to feel breathless)
How to join a clinical trial
Dr Sanjay Popat
Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer
University College London (UCL)
This is Cancer Research UK trial number CRUKE/10/040.